Multidrug-Resistant Coagulase-Negative Staphylococci Isolated from Bloodstream in the uMgungundlovu District of KwaZulu-Natal Province in South Africa: Emerging Pathogens

• Published in: Antibiotics (Basel) 2021-02, Vol.10 (2), p.198
• Main Authors: Asante, Jonathan, Hetsa, Bakoena A, Amoako, Daniel G, Abia, Akebe Luther King, Bester, Linda A, Essack, Sabiha Y
• Format: Article
• Language: English
• Subjects: Agglutination; Antibiotic resistance; Antibiotics; Azithromycin; Biochemical tests; Cefoxitin; Coagulase; coagulase-negative staphylococci; Contaminants; Drug resistance; Erythromycin; Genes; Gentamicin; Hospitals; infections; Latex; Latex agglutination; Linezolid; MecA protein; Medical equipment; Methicillin; Microbial contamination; Microorganisms; Multidrug resistance; multiple antibiotic resistance index; Neonates; Nosocomial infection; Nosocomial infections; Pathogens; Pediatrics; Penicillin; Polymerase chain reaction; public health; Sepsis; Speciation; Staphylococcus infections; Tigecycline
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics10020198

Coagulase-negative staphylococci (CoNS) are increasingly associated with nosocomial infections, especially among the immunocompromised and those with invasive medical devices, posing a significant concern. We report on clinical multidrug-resistant CoNS from the uMgungundlovu District, KwaZulu-Natal Province, South Africa, as emerging pathogens. One hundred and thirty presumptive CoNS were obtained from blood cultures. Culture, biochemical tests, and the Staphaurex™ Latex Agglutination Test were used for the initial identification of CoNS isolates; confirmation and speciation were undertaken by the VITEK 2 system. Susceptibilities of isolates against a panel of 20 antibiotics were determined using the Kirby-Bauer disk diffusion method, and the multiple antibiotic resistance (MAR) indices of the isolates were determined. The polymerase chain reaction (PCR) was used to amplify the A gene to confirm methicillin resistance. Overall, 89/130 presumptive CoNS isolates were confirmed as CoNS by the VITEK 2 system. Of these, 68 (76.4%) isolates were putatively methicillin-resistant by the phenotypic cefoxitin screen test and 63 (92.6%) were A positive. (19.1%), ssp. (15.7%), and (16.9%) were the most common CoNS species. Isolates showed high percentage resistance against penicillin (100.0%), erythromycin (74.2%), and azithromycin (74.2%) while displaying high susceptibilities to linezolid (95.5%), gentamicin (95.5%), and tigecycline (94.4%). Multidrug resistance (MDR) was observed in 76.4% of isolates. MAR index calculation revealed 71.9% of isolates with MAR index >0.2 and 20.2% >0.5. Isolates with the highest MAR indices (0.7 and 0.8) were recovered from the neonatal intensive care unit. Fifty-one MDR antibiograms were observed. The high prevalence of methicillin resistance and multidrug resistance in several species of CoNS necessitates surveillance of this emerging pathogen, currently considered a contaminant of microbial cultures.